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Mean Corpuscular Hemoglobin concentration (MCHC)

July 21, 2024HematologyLab Tests

Table of Contents

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  • Mean Corpuscular Hemoglobin concentration (MCHC)
      • What sample is needed for Mean Corpuscular Hemoglobin concentration (MCHC)?
      • How will you define Mean Corpuscular Hemoglobin concentration (MCHC)?
      • What factors interfere in estimating Mean Corpuscular Hemoglobin concentration (MCHC)?
    • What is the normal MCHC?
      • Where would you see normal MCHC values?
      • Where would you see decreased values of MCHC?
      • Where would you see increased values of MCHC?
    • Questions and answers:

Mean Corpuscular Hemoglobin concentration (MCHC)

What sample is needed for Mean Corpuscular Hemoglobin concentration (MCHC)?

  1. It is done on blood in EDTA (anticoagulant).
  2. Whole blood is stable 6 hours at 25 °C and 24 hours at 4 °C.
  3. Fetal blood is collected by percutaneous umbilical blood.

What are the indications for Mean Corpuscular Hemoglobin concentration (MCHC)?

  1. This is part of CBC (Complete blood count).
  2. This helps to diagnose the type of anemia.
  3. Mostly advised diagnosing macrocytic anemia.

How will you define Mean Corpuscular Hemoglobin concentration (MCHC)?

Definition of MCHC:

  1. This measures the average hemoglobin concentration or percentage within a single RBC.
  2. The MCHC depends on the relationship of the amount of hemoglobin to the volume of the RBC.
Mean Corpuscular Hemoglobin concentration (MCHC): MCHC formula

Mean Corpuscular Hemoglobin concentration (MCHC): MCHC formula

  1. Based on MCHC, RBCs may be classified into:
    1. Normochromic.
    2. Hypochromic.
  2. Both MCH and MCHC values determine the Hemoglobin content in the RBCs.
    1. If MCHC is normal, it is caused by low MCHC and high MCV.
  3. Then, RBCs are referred to as normochromic.
    1. If MCHC is less than normal, then RBCs are hypochromic.
  4. Hypochromic RBC when Decreased MCHC indicates low hemoglobin.
  5. The above normal level may be seen in alteration of RBC shape like spherocytosis, transfusion reaction, and erythroblastosis fetalis.

What factors interfere in estimating Mean Corpuscular Hemoglobin concentration (MCHC)?

  1. False increased MCHC is seen in the following conditions:
    1. The abnormal size of the RBCs may affect the MCHC.
    2. Increased level of lipids in the blood gives a high result because of high hemoglobin.
    3. Intravascular hemolysis gives free hemoglobin, which is calculated by the autoanalyzer.
    4. Sickle cell anemia.
    5. Hereditary spherocytosis.
    6. Few cases of autoimmune hemolytic anemia.
    7. Sever lipemia of the serum.
    8. Rouleaux formation or agglutination.
    9. In the case of increased concentration of heparin.
  2. Decreased MCHC is seen in marked leucocytosis (>50,000/cmm).

What is the normal MCHC?

Source 1

Age g Hb/dL
Fetal blood
18 to 20 weeks 32.0 ± 2.3
21 to 22 weeks 31.7 ± 2.78
23 to 25 weeks 32.1 ± 3.20
26 to 30 weeks 32.1 ± 3.60
Cord blood 30 to 36
0.5 month 28 to 35
0ne month 28 to 36
2 month 28 to 35
4 month 29 to 37
6 to 12 month 32 to 37
1 to 2 year 32 to 38
3 to 11 year 32 to 37
Male Female
12 to 14 year 32 to 37 32 to 37
15 to 17 year 32 to 36 32 to 36
18 to 44 year 32 to 37 32 to 36
45 to 64 year 32 to 36 31 to  36
65 to 74 year 31 to 36 32 to 36
  • To convert into SI unit x 10 = g Hb/L

Source 2

  • Adult = 32 to 36 g/dL or 32% to 36%
  • Newborn = 32 to 33 g/dL or 32% to 33%.

Where would you see normal MCHC values?

  • Normochromic anemia (hemolytic anemias).

Where would you see decreased values of MCHC?

  1. When MCHC is <30 g/dL.
  2. Hypochromic microcytic anemias:
    1. Iron deficiency anemia.
    2. Microcytic anemia.
    3. Chronic blood loss.
    4. Thalassemia.
Microcytosis due to low MCHC

Microcytosis due to low MCHC

Where would you see increased values of MCHC?

  1. Hereditary spherocytosis is suspected when MCHC is >36 g/dL.
  2. Newborns and infants.
  3. Erythroblastosis fetalis.
  4. Not an increase in pernicious anemia.

What is the differential diagnosis of MCHC?

MCHC decreased MCHC increased
  1. Chronic iron deficiency anemia
  2. Sideroblastic anemia
  3. Chronic disease anemia
  1. Severe plasma lipemia
  2. Heavy smoking (mild effect)
  3. Spherocytosis
  4. Intravascular hemolysis
  5. High-titer cold agglutinins

Questions and answers:

Question 1: What will be MCHC in sickle cell anemia?
Show answer
There is a false increase in sickle cell anemia.
Question 2: What is the value of decreased MCHC?
Show answer
When the MCHC is <30 g/dL.

Possible References Used
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